| NPI | 1407265663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE E ELLIS Psychotherapist 269-341-9725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301007514) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401004435) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2017-02-02 |